川崎病E-选择素水平及+A561C基因多态性研究  

Plasma E-selectin and +A561C polymorphisms in children with Kawasaki disease

作　　者：陈刚[1,2] 于明华[1,2] 曾华松[1,3] 张丽[1,2] 韦茹[1,3] 刘威[1,2] 刘特长[1,2] 

机构地区：[1]广东省广州市妇女儿童医疗中心 [2]广州市儿童医院心血管科,510120 [3]广州市儿童医院过敏免疫风湿科,510120

出　　处：《广东医学》2010年第1期23-27,共5页Guangdong Medical Journal

基　　金：广东省自然科学基金项目(编号:9151026003000004);广东省社会发展领域科技计划项目(编号:63097)

摘　　要：目的探讨E-选择素在川崎病病情监测与冠状动脉病变程度的作用,以及E-选择素+A561C位点单核甘酸多态性与川崎病发病及冠脉损害以及对E-选择素水平的影响。方法川崎病组148例、发热组20例和对照组160例,其中川崎病组包括冠状动脉损伤组(coronary artery lesion,CAL)78例和非冠状动脉损伤组(no coronary artery lesion,NCAL)70例进行调查。应用酶联免疫吸附实验(ELISA)双抗体夹心法检测E-选择素血浆水平。聚合酶链反应-限制性片段长度多态性技术检测E-选择素+A561C位点单核甘酸多态性在川崎病组和对照组中的基因频率分布。结果川崎病组E-选择素与发热组、对照组比较:急性期(193±29)ng/mL、亚急性期(150±48)ng/mL均高于发热组(115±23)ng/mL和对照组(80±16)ng/mL,差异有显著性(P<0.01);急性期冠脉损伤组[(226±36)ng/mL]E-选择素水平明显高于无冠脉损伤组[(158±31)ng/mL]差异有显著性(P<0.01)。亚急性期[(174±46)ng/mLvs(125±28)ng/mL]和恢复期[(108±15)ng/mLvs(83±19)ng/mL]差异无显著性。E-选择素+A561C各基因型分布以及等位基因频率在川崎病组和对照组之间比较差异无显著性(P>0.05),在与合并冠状动脉损伤组间比较无显著性(P>0.05)。川崎病组AC基因型携带者与AA基因型的E-选择素水平差异无显著性。结论E-选择素与川崎病以及冠脉损伤的发生、发展关系密切,E-选择素具有预示川崎病患儿冠状动脉损伤潜在的可能性。研究对象中存在E-选择素+A561C位点基因多态性,未发现E-选择素+A561C位点基因多态性与川崎病的相关性。Objective To investigate the correlation among E - selectin, E - selectin A561C polymorphism and Kawasaki disease （KD） Methods The plamsa level of E - selectin was determined by ELISA. PCR - RFLP method was used to determine ＋ A561C locus mutation polymorphisms in E -selectin gene. Gene polymorphisms were confirmed by sequencing analysis. Results ES levels in acute phase group [ （ 193 ± 29） ng/mL ] and subacute phase group [ （ 150 ± 48） ng/mL] were significantly higher than those in the control group（P 〈 0.01 ）. The peak level of ES [ （193±29） ng/ mL]appeared in the acute phase. Plasma ES levels in CAL group were significantly higher than those in NCAL group in the acute phase [ （226 ± 36） vs （ 158 ±31 ） ng/mL ] （ P 〈 0. 01 ）. E - selectin gene ＋ 3.561 C polymorphism occurred in children, The frequency of AA genotype was the highest among all E - selectin genotypes （92. 5% ）, and these patterns showed no significant difference between male and female （P 〉 0. 05 ）. The allele frequencies of ＋ A561C site of E -selectin gene had no significant difference between children with or without KD, and between CAL and NCAL. There was no significant difference in the levels of ES among different genotypes. Conclusion E - selectin is closely associated with the pathogenesis of CAL in children with KD and may be a potential biological predictor. ＋ A561C polymorphism of E - selectin is not associated with the pathogenesis of KD.

关 键 词：川崎病 E-选择素 单核甘酸多态性 

分 类 号：R541.4[医药卫生—心血管疾病] R587.1[医药卫生—内科学]